External versus internal cardioversion for atrial fibrillation: a meta-analysis of randomized controlled trials

Gaurav Aggarwal, Mahesh Anantha-Narayanan, Julian Robles, Dhrubajyoti Bandyopadhyay, Mary Abed, Brandon Michael Henry, Saurabh Aggarwal, Venkata Alla

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Patients with atrial fibrillation (AF) often require rhythm control strategy for amelioration of symptoms. It is unclear if there is any difference between external cardioversion (ECV) and internal cardioversion (ICV) for successful conversion of AF to normal sinus rhythm. Methods: We performed a meta-analysis of published randomized controlled trials (RCTs) evaluating success of cardioversion using ECV versus ICV. Results: In the pooled analysis of 5 RCTS, there was no difference in success of cardioversion using ECV versus ICV (OR 1.69, 95% CI 0.24–11.83, p = 0.6). In the subgroup analysis, there was no difference between ECV and direct electrode ICV (OR 0.41, 95% CI 0.09–1.83, p = 0.24). However, ECV was significantly better compared with ICV using ICD (OR 11.97, 95% CI 1.87–76.73, p = 0.009). Conclusions: There was no difference between ECV versus ICV in effectiveness for termination of AF. Larger well-designed randomized controlled trials are needed to confirm our findings.

Original languageEnglish (US)
Pages (from-to)445-451
Number of pages7
JournalJournal of Interventional Cardiac Electrophysiology
Volume61
Issue number3
DOIs
StatePublished - Sep 2021

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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